COMPT inhibitors friend or foe?

[134A]

I am experiencing diskenesia about an hour to an hour and a half after a single 25/100 CL dose. A physician (not mine ) has suggested Entacapone might help reduce the unwanted movement and increase the “on” time . I’m reluctant to add more drugs but diskenesia is limiting my daily activities and driving me to sit on the couch way too much.

Any thoughts?

[laglag]

I took it a few years ago and I started talking and shouting at night. I switched to Gocovri but it's expensive.

[134A in reply to laglag]

thanks lag. I don’t like the sound of that night action. Does the Gocovri help?

[park_bear]

Dyskinesia is caused by high peak plasma levels of levodopa. One solution would be to take half doses of the 25/100 more frequently. A better solution, in my opinion, is to take the extended release version of C/L which delivers more even plasma levels and a lower peak. See my post here for details:

healthunlocked.com/cure-par...

[134A in reply to park_bear]

thanks Park Bear. I have tried taking half tablets but I get hardly any on time and still get diskenesia. I got diskenesia from day one taking C/L which I understand is unusual . I am five years diagnosed but took no meds for the first two years. Tried agonists but they made me dizzy so I went back to C/L.

Might ask about extended release when I see my neurologist in a couple of weeks.

Thanks again

[LAJ12345]

if it’s happening an hour and a half after a dose it means it’s probably too much. If it’s a tablet you can cut try cutting it in half and take the halves about 3.5 hours apart. See if that helps.

Ah , I just saw above answer. Perhaps try the halves 2 hours apart.

Be careful with the extended release. They made my husband extremely I’ll and if a full dose is too strong for you they may be too. How many 100/25 do you take a day?

[134A in reply to LAJ12345]

thanks, I have tried half tablets but got little effect re on time and still had as much diskenesia as with the whole tablet. From the other replies it looks as if Entacapone doesn’t help with the diskenesia much.

Thanks for your response

[Zella23]

My husband got dyskinesia about 5 years into PD from CL. Needed more CL for movement but didn’t want more dyskinesia so was prescribed Rasagaline then Amantadine. That really helped.

He still gets dyskinesia but mildly, and not so frequently. Has cut CL down to 3 x100 a day but keeps with the other meds. Recent visit to Neuro he said he can add 2 more Amantadine if dyskinesia is a problem. He experienced the dyskinesia at the Neuro appointment, but we felt the Neuro had seen much worse! He linked it to mild anxiety, which we do notice increases it.

[134A in reply to Zella23]

thanks Zella

Does he still take the Rasiligine along with the others? I had it for a while but it made me quite dizzy and unstable on my feet so I quit it. I haven’t had Amantadine.

[134A in reply to 134A]

sorry read your message again. Looks like he does still have the Rasagilene

Thanks

[Doohat]

Be sure to try the control/timed release version of C/L, which is normally sold as a generic. Note: The extended release is sometimes confused with Rytary, which is a combination of immediate & timed release C/L. I've taken Entacapone and it seems to have very little effect. You might get an extra 30 minutes to an hour of on-time.

[134A in reply to Doohat]

thanks Doohat

[hercules957]

I have diphasic dyskinesia which means I get it at peak plasma and just before the next dose; fortunately mildly. I take Entacapone to extend the levodopa life it has no effect on dyskinesia.

[134A]

thanks Hercules

[mleec]

I am 5 years from diagnosis and started amantadine over a month ago. I was having more off than on time the doctor covering for my neurologist increased my C/L to 2 tablets of 25/100. This wasn’t helping so at night I would take a CR version of C/L in addition to the daytime doses. My own neurologist returned to work and added the amantadine. I was to start with 2.5ml 3x per day and work myself up to 10 ml .3x per day. The first day made me nauseous. So I went down to 2 doses a day. It took me over 2 weeks to get to 5ml but I have been at the 5 mls for about 4 weeks and it appears my dyskinesia has improved. I much fewer “off” events, I am on most of the day and able to do what I want. I am not going to increase the dose if this amount is working. The only inconvenience is that it is in a liquid format so traveling with a liquid medication is a real pain. But I am grateful it is working because I had my doubts.

[134A in reply to mleec]

thanks mleec

I’m happy to hear that you were able to improve your symptoms.

What is the advantage of taking the CR version at night?

[mleec in reply to 134A]

I was having a lot of cramping in my legs and waking up and not sleeping to begin with. I felt like the regular C/L was not holding me through the night. The CR is a 50/200 dose. The amantadine appears to equalize or keep the C/L steady over the course of the day. At least that is how I understand it.

[134A in reply to mleec]

ok thanks